Many wounds and surgical incisions are closed using surgical sutures or some other surgical closure device. Barbed sutures are well known and have recently been gaining attention for various medical applications. Typically, barbed sutures are constructed with a series of “barbs” or “protrusions” (used interchangeably herein) that extend outwardly from the suture and function to increase the holding strength of the suture and/or eliminate the need for knot tying. The size and shape of the barbs have practical limitations in a surgical setting.
Barbed sutures are available as both “uni-directional” and “bi-directional” in design. Bi-directional barbed sutures have barbs in two opposing directions on each side of a central region, with needles at both the first and second ends. Typically, closure using these devices starts in the center of the incision, and each half of the incision is closed by stitching from the center outwards towards the ends using the respective first and second needles. Uni-directional barbed suture devices have all of the anchors or barbs facing in one direction, and a needle only at a first end. These devices are applied from one end of the incision to the other.
Some uni-directional barbed sutures include an anchor, tab, loop or the like on the distal end of the suture to provide a “stop” that contributes to the holding strength of the suture and eliminates the need to tie knots to secure the suture on initiation of the closure. The term “stop element” is used herein to refer to any such element regardless of design or type. One such device is disclosed in pending U.S. patent application Ser. No. 13/248,542, filed on Sep. 29, 2011 (Publication No. US2013/0085525), which is incorporated herein by reference in its entirety. With sutures of this type, however, in certain instances and when placed in certain ways, users have been known to pull too hard on the suture and exceed the holding strength of the stop element or compromise the integrity of the stop element. The present invention provides an improved method for using a uni-directional barbed suture having a stop element by which the holding strength of the suture can be greatly increased.